Circulation
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Comparative Study
Benefit of bilateral over single internal mammary artery grafts for multiple coronary artery bypass grafting.
The aim of this study was to evaluate the performance of bilateral internal mammary artery (BIMA) grafts in isolated CABG. ⋯ Our data suggest that the use of BIMA grafts in patients with in situ coronary artery anastomoses achieves a significantly higher repeated CABG-free rate in all patients compared with the use of SIMA.
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Multicenter Study Clinical Trial
Mechanism of syncope in patients with bundle branch block and negative electrophysiological test.
In patients with syncope and bundle branch block (BBB), syncope is suspected to be attributable to a paroxysmal atrioventricular (AV) block, but little is known of its mechanism when electrophysiological study is negative. ⋯ In patients with BBB and negative electrophysiological study, most syncopal recurrences have a homogeneous mechanism that is characterized by prolonged asystolic pauses, mainly attributable to sudden-onset paroxysmal AV block.
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Acute cardiac contractile dysfunction is common after cardiopulmonary bypass (CPB). A potential molecular mechanism is enhanced beta-adrenergic receptor kinase (betaARK1) activity, because beta-adrenergic receptor (betaAR) signaling is altered in cardiomyocytes after cardioplegia. Therefore, we examined whether adenovirus-mediated intracoronary delivery of a betaARK1 inhibitor (Adv-betaARKct) could prevent post-CPB dysfunction. ⋯ Myocardial gene transfer of Adv-betaARKct stabilizes betaAR signaling and prevents LV dysfunction induced by prolonged cardioplegic arrest. Thus, betaARK1 inhibition may represent a novel target in limiting depressed ventricular function after CPB.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Early outcome after off-pump versus on-pump coronary bypass surgery: results from a randomized study.
The use of cardiopulmonary bypass during coronary artery bypass surgery (CABG) has been associated with substantial morbidity. The recent introduction of cardiac stabilizers facilitates CABG without cardiopulmonary bypass (off-pump CABG), but it is unknown whether cardiac outcome after off-pump surgery is similar to that for the on-pump procedure. ⋯ In selected patients, off-pump CABG is safe and yields a short-term cardiac outcome comparable to that of on-pump CABG.